What’s the deal with HPV?

HPV stands for Human Papilloma Virus. There are over 100 strains of HPV, about 30 of which can be sexually transmitted. HPV can cause a number of different diseases including genital warts and cervical cancer, as well as other less common cancers of the anus, penis, vulva and vagina. Different strains of HPV cause different diseases; the “low-risk” types are more likely to cause genital warts while the “high-risk” types are more likely to lead to cancer.

The CDC (Centers for Disease Control and Prevention) estimates that about 50% of sexually active men and women will get HPV at some time in their lives.  Most people who have HPV have no visible signs of infection, so they spread it to their partners without even knowing they have it.  HPV is spread by direct skin-to-skin contact so you can get it even if you are using a condom.  There is no medical treatment for HPV but fortunately, in about 90% of cases an individual’s immune system will get rid of the virus on its own within two years. 

It is very important that all sexually active women receive an annual exam and Pap smear.  Your health care provider will examine you for genital warts and/or signs of precancerous changes of the cervix called “cervical dysplasia.” Cervical cancer is most successfully treated when it is caught early.

A vaccine that protects against the four most common strains of HPV is now available for women ages 9-26. This vaccine will greatly decrease your chances of becoming infected with one of the viruses that can cause cervical cancer.  If you’ve already been infected with one of these four strains, the vaccine won’t cure you but it can prevent you from getting one of the other types.  Even if you do get the vaccine, it is very important that you still go for your regular Pap smears.

The staff at Student Health Women’s Services is happy to answer any of your questions, perform all recommended exams and tests, and provide the HPV vaccine.  In the mean time, here are some other good sources of reliable information:

http://www.cdc.gov/std/hpv/    http://www.ashastd.org/hpv/hpv_learn_myths.cfm

Angie Walker, Med IV (Ohio State College of Medicine)

John A. Vaughn, MD (Ohio State Student Health Services)

Medical Mythbusters – Eating late at night makes you fat!

TRUE OR FALSE: Late night snacks make you fat

A: FALSE!

Weight loss is one of those topics on which medical myths abound – in fact, one stroll through Barnes and Noble will show you how many people are making a mint by promoting them. One of the ones we hear all the time is that eating late at night makes you fatter than eating earlier in the day.  Fortunately for those of us midnight snackers, new research has shown that this is total bunk. While technically speaking our metabolism slows down a little bit at night, the simple truth remains: if you eat more calories than you burn, you’ll gain weight and if you eat fewer calories than you burn, you’ll lose weight – no matter what time of day it is.  

Granted, if you find yourself taking a big bowl of ice cream to bed every night, or indulging in nightly wine & cheese, you’re going to pack on some pounds, but no more so than if you had that bowl of ice cream for breakfast.  

It’s probably still a good idea to avoid eating late at night.  Eating right before you lie down puts you at an increased risk for acid reflux, a condition in which food contents and digestive acids from the stomach splash back up into the esophagus causing an uncomfortable burning sensation in the chest (“heartburn”).  If that occurs, be sure to let your health care provider know.  And leave the Oreos alone unti the sun comes up…

Angie Walker, Med IV (OSU COM)

John A. Vaughn, MD (OSU SHS) 

Oops, we did it again!

Over the past decade or more, we have seen promising trends in the data measuring the sexual and reproductive health of adolescents and young adults.  In surveys focused on the 10-24 year age group in the US, the Centers for Disease Control and Prevention (CDC) has measured birth rates, new cases of HIV, gonorrhea, chlamydia, syphilis, as well as risky sexual behaviors. 

However, in the past few years, we are seeing some of the same-old problems starting to reappear:

  • Birth rates that had declined from 1991-2005 have increased from 2005-2007
  • New HIV diagnosis rates in men 15-19 years old have nearly doubled in the past ten years
  • Declining rates of gonorrhea have slowed and leveled off
  • Syphilis rates increased from 2004-2006 after steadily declining from 1997-2004.

(Visit Sexual and Reproductive Health of Persons Aged 10–24 Years report from the CDC for more details of this study.)

Public health researchers are working to evaluate these trends and the reasons behind them.  BuckMD would like to hear from you – what do you think is happening with adolescents and young adults, and their risk behaviors?  Post a comment and let’s start a discussion.  Your identity will be strictly confidential.

Roger Miller, MD for BuckMD

 

Create a Flu Video for a chance to win $2500!

Thanks to our Ohio State University Office of Student Life – Inspire USA online film competition earlier this year, Ohio State students have already shown the world their creativity and commitment to making the world a healthier and safter place.  In the process, they won some great financial awards that they have used to support more academic and creative endeavors.

Well, thanks to a new contest being sponsored by the Department of Health and Human Services, Buckeyes are getting another chance to show what they can do.   Not only will the person who posts the winning short online video about flu safety to YouTube win $2500, they will appear on national TV!  You can learn more about the contest here and by watching this brief video.  Good luck and Go Bucks!!

Getting the word out on flu from OSU Student Health!

Dr. Roger Miller, our Senior Manager of Preventive and Complementary Care here at Ohio State Student Health Services, discussed campus preparedness for H1N1 (“Swine”) flu in the fall with Dr. Nancy Synderman today on the “Dr. Nancy” show on MSNBC.  Dr. Miller and the Student Health Services team of providers, nurses, and support staff have been spearheading these efforts on our campus and this national recognition is a testament to their success. 

You can watch the interview here

Go Bucks!

How Much Does Grad School Suck?

In the dark days of medical school – when I was routinely forced to confront unpleasant body parts and their various emanations, practice painful procedures on innocent victims (er… patients) and cope with the general unpleasantness of death and illness – I would often daydream about chucking it all and going to grad school.  I was an English major here at Ohio State and had visions of sitting around in a beret at Larry’s, thinking deep thoughts, writing the occasional paper, grading the occasional essay test.   

But since coming back to work at Student Health Services, I’ve noticed a recurring theme – I’m caring for a lot of very stressed out grad students around here.  And I thought that since the concept of “summer vacation” is about as relevant to grad students as “disposable income,” now would be a good time to review the various ways in which grad school is a royal pain in the Bunsen burner.

This post is probably everything it’s not supposed to be: it’s too long, it’s got no celebrity pictures or videos of roller-skating babies… I’m not even sure how medically relevant it is.  But I’m a big believer in the therapeutic value of a good group beyotch session, so here goes.

Your life is at the whim of one person for like 6 years…

There’s no doubt that medical training is chock full of personality disorders, but the beauty is that you never spend more than one month on a given rotation.  So even if you get stuck with the surgeon who throws scalpels at students for target practice or the psychiatrist who asks you to psychoanalyze her cat, you know that it’ll be over in a few short weeks. 

If, however, you don’t e-harmonize with your grad school advisor, you’re looking at a prison sentence along the lines of armed robbery.  What’s that, you don’t want to work every weekend?  Don’t want to teach an extra class?  Don’t want to go into academia?  Fine, your candidacy exam will now consist of reciting the complete text of Beowulf in the original Old English –I don’t care that you’re in the Biochemistry program!  You could switch advisors, but then you risk being labeled a “trouble maker” and alienating other faculty in your department, not to mention losing 2 years of your life to a scrapped project.

Money matters

As I was racking up enormous med school loans, I again thought grad students had it made – you get a graduate assistant position and your degree is free.

This may be kinda sorta true, but the flip side is that the funding that supports grad students can be surprisingly tenuous.  If your advisor’s grant doesn’t get renewed or the industry you’re working with decides they can’t afford to support the R&D anymore, all of a sudden your ability to continue your education – and your career – is in doubt.  Med school loans are no fun, but at least I never had to worry about someone coming in and saying, “Yeah, it looks like this whole ‘Ohio State Medical Center’ concept isn’t going to pan out, so we’re going to shut this baby down.”

Family planning

On top of the stress of work, little things like marriage and children tend to pop up during grad school.  This can be very stressful, especially for women.  Focusing on the nuances of macro-economics or mechanical engineering is tough enough – trying to do it while planning a wedding in Albuquerque with a future mother-in-law who is already plotting your demise is next to impossible.  And sure, you’re entitled to maternity leave, but no one’s working on that dissertation for you while you’re up at 3am changing diapers for 6 weeks.  You may think that you’ll be able to ‘get some work done from home’ but with infants you’re lucky if you get to use the bathroom without back-up, let alone think on a critical level.  Unless your research is on the cerebral softening effect of watching Baby Einstein videos 400 times a week, you’re out of luck.  Of course, you could “take some time off”… and end up in the Lantern 20 years from now: “Mother and Child graduate from OSU together!”

A Stranger in a Strange Land

Plymouth Rock… Ellis Island… Columbus, Ohio?  This country was built by people who came here in search of something better for themselves and their families.  That whole “American Dream” thing is not just a cliché, my friends, and it’s not just history – it happens on this campus every year when international students come here for their graduate studies. 

But the American Dream comes with a price.  Take all of the above stressors and add the following: cultural barriers, language barriers, visa barriers, a spouse who feels isolated while you’re at work all day (or is living 6,000 miles away), the expectations of parents who gave up everything they had so you could be here, the loss of the social support network of friends/family, heck… not knowing where to find recognizable food!

…. [deep breath]….

While these pressures are certainly not all unique to the grad school pressure cooker, they often come to a boil there.  And when that happens, lots of problems can pop up that make life miserable: trouble sleeping, trouble concentrating, anxiety and depression, stomach pain, sexual dysfunction, weight gain, substance abuse, the list goes on. 

So what do you think – am I right or am I crazy?  Post a comment and let me know (don’t worry – it’s anonymous).  After we’re done venting, we’ll be a little more constructive and use the next post to talk about the resources on campus that can help you find healthy ways to deal with all of this stuff.

John Vaughn, MD

Why does my girlfriend pee after we have sex?

Q:  My girlfriend usually gets up to pee after we have sex, but the last few times she hasn’t.  Is she trying to get pregnant?

A:  Fear not – your girlfriend’s bathroom break has nothing to do with getting pregnant.

Sexual intercourse is one of the biggest risk factors for women developing a urinary tract infection (“UTI,” “bladder infection”).  The urethra, which is the tube that connects the bladder to the outside of the body, is right next to the vaginal opening.  Bacteria from the gastrointestinal tract can sometimes colonize the vagina, and during sex this bacteria can work its way up the urethra and infect the bladder or kidneys. 

Although research studies have never actually proven its benefit, most women have been told by their healthcare provider to urinate immediately after intercourse to help prevent an infection – hence the quick trip to the bathroom when you’re done. 

Of course, the best way to know if your girlfriend is trying to get pregnant is to ask her.  While it is often difficult to talk about sex stuff, if you’re really worried about something as serious as that, you’ve got to speak up or zip up before you end up in a terrible situation. 

John A. Vaughn, MD

Will my buddy make me fail a drug test?

Q: While I was at ComFest a few weeks ago I was around a lot of people who were smoking pot. I have a urine drug test coming up and I’m wondering if I might test positive.

A: The urine marijuana test detects a chemical called tetrahydrocannabinol (THC), which is the active drug in marijuana. THC is stored in body fat and excreted in the urine. For someone who smokes a single marijuana cigarette, THC metabolites are detectable for several days. For chronic marijuana smokers, the level of THC builds up in the body fat over time and is excreted for weeks after the last time they used the drug.  Urine drug tests are set with a high threshold to eliminate false positives (people that test positive but do not use the drug).

Traces of marijuana may be detectable in the urine for a day or two in someone who was around marijuana smoke, but if you didn’t personally smoke it, you likely have nothing to worry about.  Smelling marijuana smoke at an outside event is very unlikely to result in a positive test, but it’s probably a good idea to avoid enclosed areas where people are smoking, like cars and closed rooms.  

Measles Initiative

Unless you’re taking a class in the history of infectious diseases – or ever tried to decipher those scribbles on your childhood immunization records that you had to dig out when you came to campus – you’ve probably never heard of measles.  You were likely vaccinated against this disease back when you were learning to walk, and didn’t really care much at the time. 

However, did you know that measles is still a major threat in many developing parts of the world, and that over 600 children a DAY die from this disease? 

The Immunization Action Coalition is an organization that promotes education and information on vaccine-related topics.  Recently, their Video of the Week caught BuckMD’s eye.  It is from the Measles Initiative, a collaborative effort of the CDC, World Health Organization, UNICEF, the United Nations Foundation, and the American Red Cross, that involves youth advocates in educating and raising awareness of global measles prevention efforts. 

Click below to see these guys in action and learn how you can GET ACTIVE, GET INVOLVED!

 

Best of Health!

 

Roger Miller, MD for BuckMD

More Sex Talk!

Today, we continue our discussion of real sexual health questions submitted by real Ohio State students.  At first glance, this question seems kind of… obvious.  But that cliché about no such thing as a dumb question is true; there’s more to this “stupid” question than meets the eye.  And if this student was brave enough to ask it, that means that there are a lot more people out there who are wondering the same thing.  Please post a comment and let us know what you think – remember, it’s anonymous.

Q: Is it possible to get pregnant from anal sex?

A: Technically speaking… no.  The anus and the gastrointestinal tract are not connected to the reproductive tract in any way.  There are some rare conditions in which an abnormal connection called a fistula could form between the two tracts, but if you were dealing with something like that, having anal sex would be about the last possible thing on your mind – and even if it wasn’t, the sperm would never survive the trip across the fistula. 

Theoretically speaking… it’s possible, but highly unlikely.  If, during the course of having anal sex, sperm were to somehow land on the vaginal opening and work its way all the way up to the cervix, pregnancy could occur.  But this is very unlikely to happen without vaginal penetration.  The only other conceivable (ha ha) way pregnancy could occur is if you and your partner have a frighteningly bad sense of direction and are NOT where you think you are.

But let’s get to the real issue here.  A lot of people believe that anal sex or oral sex isn’t “real” sex.  Perhaps from a technical – or political – standpoint that may be true, but in reality, that’s a dangerous fiction.  You may not have to worry about getting pregnant, but unprotected anal sex puts you at risk for all of the same sexually transmitted infections that “real” sex does: HIV, HPV, gonorrhea, Chlamydia, herpes, you name it.  In fact, anal sex can put you at an even higher risk for these infections because the anus and rectum aren’t as pliable as the vagina, so there is a greater chance of having a tear and bleeding that increases the likelihood of transmission.

And remember, the “realness” of anal sex (or oral sex or elbow sex or any sex) applies to its emotional and psychological impact as well.  Physical intimacy can have significant and unpredictable consequences that go way beyond infections.  I’ve cared for many patients who came in “just to get tested” but who were really dealing with significant anxiety and other stress-related symptoms. 

So if you don’t feel comfortable doing something, never let anyone talk you into it because it “doesn’t really count.”  And whenever you do decide to have sex with someone, always protect yourself – no matter what you’re doing. 

 

John A. Vaughn, MD

Adam Brandeberry, Med IV, OSU COM